Examining Interventions Designed to Support Shared Decision Making and Subsequent Patient Outcomes in Palliative Care: A Systematic Review of the Literature.

Only English-language studies were included. The participants were mostly older adults and mostly white, so the review may not apply to other cultural or age groups. The 12 studies used different designs, interventions, measurements, and outcomes, so the reviewers could not combine them in a meta-analysis. Some randomized trials did not clearly report allocation concealment or blinding, and other studies had selection bias, low response rates, missing data, or unclear measurements. The studies did not confirm whether the amount or frequency of shared decision making was enough to change outcomes. The technology-based tools were global rather than individualized. Three studies used mixed delivery modes, such as video, print materials, and structured meetings, so the contribution of any single component cannot be separated.

Do not conclude that palliative care decision aids reliably improve patient outcomes. Knowledge and communication improved in some studies, but satisfaction, decision quality, quality of life, directive completion, and healthcare use did not consistently change.